CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Monroe County Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,282
Cash Discount Price: $2,741
vs. Medicare Baseline: 6.40x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Monroe County Hospital is $2,282. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,741. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.40x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$2,741

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,282

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $2,741 (769%)

Insurance Median: $2,282 (640%)

Cash: $2,741 (769% of Medicare)

Ins. Median: $2,282 (640% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 640% of the Medicare baseline (a markup of 540%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Wellmark Hmo	$556	156%
Wellmark Ppo - All Other Plans	$599	168%
Mahp Mcare - All Plans	$1,903 - $1,934	534%
Tricare	$1,903 - $1,934	534%
UnitedHealthcare	$1,903 - $4,374	534%
Va Ccn - All Plans	$1,903 - $1,934	534%
Amerigroup Mcare	$1,922 - $1,953	539%
Humana	$1,922 - $1,953	539%
Wellmark Mcare	$1,922 - $1,953	539%
Aetna	$1,942 - $4,328	545%
Iowa Total Care Mcaid - All Plans	$2,265 - $2,301	635%
Molina Mcaid - All Plans	$2,299 - $2,335	645%
Amerigroup Mcaid - All Other Plans	$2,332 - $2,369	654%
Centivo - All Plans	$2,855 - $2,901	801%
Midlands Choice - All Plans	$3,172 - $3,223	890%
Preferred Hlth - All Plans	$3,399 - $3,453	954%
Geha - All Plans	$3,626 - $3,683	1017%
Multiplan - All Plans	$4,079 - $4,144	1144%
Integrated Hp - All Plans	$4,396 - $4,466	1233%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,741.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Monroe County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.